Corante

About this Author
DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: derekb.lowe@gmail.com Twitter: Dereklowe

Chemistry and Drug Data: Drugbank
Emolecules
ChemSpider
Chempedia Lab
Synthetic Pages
Organic Chemistry Portal
PubChem
Not Voodoo
DailyMed
Druglib
Clinicaltrials.gov

Chemistry and Pharma Blogs:
Org Prep Daily
The Haystack
Kilomentor
A New Merck, Reviewed
Liberal Arts Chemistry
Electron Pusher
All Things Metathesis
C&E News Blogs
Chemiotics II
Chemical Space
Noel O'Blog
In Vivo Blog
Terra Sigilatta
BBSRC/Douglas Kell
ChemBark
Realizations in Biostatistics
Chemjobber
Pharmalot
ChemSpider Blog
Pharmagossip
Med-Chemist
Organic Chem - Education & Industry
Pharma Strategy Blog
No Name No Slogan
Practical Fragments
SimBioSys
The Curious Wavefunction
Natural Product Man
Fragment Literature
Chemistry World Blog
Synthetic Nature
Chemistry Blog
Synthesizing Ideas
Business|Bytes|Genes|Molecules
Eye on FDA
Chemical Forums
Depth-First
Symyx Blog
Sceptical Chymist
Lamentations on Chemistry
Computational Organic Chemistry
Mining Drugs
Henry Rzepa


Science Blogs and News:
Bad Science
The Loom
Uncertain Principles
Fierce Biotech
Blogs for Industry
Omics! Omics!
Young Female Scientist
Notional Slurry
Nobel Intent
SciTech Daily
Science Blog
FuturePundit
Aetiology
Gene Expression (I)
Gene Expression (II)
Sciencebase
Pharyngula
Adventures in Ethics and Science
Transterrestrial Musings
Slashdot Science
Cosmic Variance
Biology News Net


Medical Blogs
DB's Medical Rants
Science-Based Medicine
GruntDoc
Respectful Insolence
Diabetes Mine


Economics and Business
Marginal Revolution
The Volokh Conspiracy
Knowledge Problem


Politics / Current Events
Virginia Postrel
Instapundit
Belmont Club
Mickey Kaus


Belles Lettres
Uncouth Reflections
Arts and Letters Daily
In the Pipeline: Don't miss Derek Lowe's excellent commentary on drug discovery and the pharma industry in general at In the Pipeline

In the Pipeline

« Extortion, Retractions, And More | Main | Carl Icahn Going For Genzyme? »

January 7, 2010

Is XMRV the Cause of Chronic Fatigue Syndrome? Or Anything?

Email This Entry

Posted by Derek

Last fall it was reported that a large proportion of patients suffering from chronic fatigue syndrome also showed positive for a little-understood retrovirus (XMRV). This created a lot of understandable excitement for sufferers of a conditions that (although often ill-defined) seems to have some puzzling biology buried in it somewhere.

Well, let the fighting begin: a new paper in PLoS One has challenged this correlation. Groups from Imperial College and King's College have failed to detect any XMRV in a similar patient population:

. . .Unlike the study of Lombardi et al., we have failed to detect XMRV or closely related MRV proviral DNA sequences in any sample from CFS cases. . .Based on our molecular data, we do not share the conviction that XMRV may be a contributory factor in the pathogenesis of CFS, at least in the U.K.

Interestingly, XMRV has also been reported in tissue from prostate cancer patients, but recent studies in Germany and Ireland failed to replicate these results. Could we be looking at a geographic coincidence, a retroviral infection that's found in North America but not in Europe, and one whose connection with these diseases is either complex or nonexistent?

Note: as per a comment on this post, the Whittemore Peterson Institute is firing back, claiming that their original work is valid and that the London study has many significant differences. PDF of their release here.

Comments (94) + TrackBacks (0) | Category: Biological News | Cancer | Infectious Diseases


COMMENTS

1. sgsox on January 7, 2010 12:22 PM writes...

WPI immediately published a very strong worded press relaes, basically calling the new study a total rubbish.
http://www.wpinstitute.org/news/docs/WPI_Erlwein_010610.pdf

It should be noted that WPI is currently making/selling test for XMRV and may be a bit incensed...

Permalink to Comment

2. Sili on January 7, 2010 1:05 PM writes...

It's always fun to see that Big Quacka have worse ethics than Big Pharma.

You and ERV show up right next to eachother in my feed. Pretty damn fast you are.

Permalink to Comment

3. cynical1 on January 7, 2010 2:01 PM writes...

And you can just bet that this marks the start of yet another bitter academic fracas between all parties that will sideline the real issue - which just happens to be a ton of people who are really, really sick.

Here's an idea: Why didn't they just send their plasma samples to each other and see what they could figure out? Is that so hard? (I'll even buy the dry ice for them to ship it in!) And maybe, just maybe, it might have been wiser to do this BEFORE the war gets started.

But no.......

One of these groups has very likely screwed up (I seriously doubt a disparate etiology between continents)and I'll predict that they'll fight to the end of their careers defending their results. Do the words, 'Sorry, I was mistaken' ever pass over the lips (or across the keyboard) of scientists?

Researchers can be such wankers........Sorry, for some reason, I'm feeling more cynical than usual today. Maybe it's all those people that Merck and Pfizer are firing.

Permalink to Comment

4. arglebargle on January 7, 2010 4:49 PM writes...

This new study which did not find XMRV likely has problems with both their cohort selection and methodology. It looks like their selection criteria would actually exclude ME/CFS patients. People who are ill with ME/CFS have measurable abnormalities in a number of areas yet the study states "Patients in our CFS cohort had undergone medical screening to exclude detectable organic illness and met the CDC criteria for CFS.". in addition, the CDC criteria are very loose and set up to support Dr. Reeves of the CDC's contention that ME/CFS is totally psychological in nature. Seems like the fix is in WRT this study as the psych camp tries to protect their turf despite the weight of thousands of patients who have well documented physical illness.

Also, microbes do not respect international borders, especially in this age of high speed travel. XMRV was found in one prostate cancer case and one control in the following study.

J Clin Virol. 2008 Nov;43(3):277-83. Epub 2008 Sep 27.

Prevalence of human gammaretrovirus XMRV in sporadic prostate cancer.
Fischer N, Hellwinkel O, Schulz C, Chun FK, Huland H, Aepfelbacher M, Schlomm T.

Institute for Medical Microbiology and Virology, University Medical Center Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. nfischer@uke.de

Permalink to Comment

5. Anonymous on January 7, 2010 5:21 PM writes...

It was pretty obvious that the initial study was non-specific and non-robust PCR amplification conditions. Its pretty funny that in their press release they claim that the new study is no good in part because of "use of a molecular plasmid control in water versus a positive blood sample."

That is like one of the most damning little sentences I've read in a while. The "positive blood sample" that they claim is the best positive control was only deemed positive by virtue of the same assay that it is supposed to be the positive control for. The initial study had no real positive control, and therefore was fatally flawed.

Permalink to Comment

6. Anonymous on January 7, 2010 5:22 PM writes...

It was pretty obvious that the initial study was non-specific and non-robust PCR amplification conditions. Its pretty funny that in their press release they claim that the new study is no good in part because of "use of a molecular plasmid control in water versus a positive blood sample."

That is like one of the most damning little sentences I've read in a while. The "positive blood sample" that they claim is the best positive control was only deemed positive by virtue of the same assay that it is supposed to be the positive control for. The initial study had no real positive control, and therefore was fatally flawed.

Permalink to Comment

7. Whittemore Peterson Institute on January 7, 2010 5:25 PM writes...

FOR IMMEDIATE RELEASE

Frankie Vigil
R&R Partners for
Whittemore Peterson Institute
775-336-4555
frankie.vigil@rrpartners.com

Official Statement from the Whittemore Peterson Institute Regarding UK Study

The Whittemore Peterson Institute (WPI) has reviewed the paper entitled “Failure to Detect the Novel Retrovirus XMRV in Chronic Fatigue Syndrome.” This study did not duplicate the rigorous scientific techniques used by WPI, the National Cancer Institute and the Cleveland Clinic, therefore it cannot be considered a replication study nor can the results claim to be anything other than a failure not just to detect XMRV, but also a failure to suggest meaningful results.

The scientific methods used by WPI are very exact and require specific techniques to ensure accuracy. Differences in techniques employed by Erlwein et al. not only explain their failure to replicate the WPI study, but also render the conclusions meaningless. These differences include, but are not limited to the following:

1) blood sample volumes and processing;
2) patient criteria/population differences;
3) number and type of tests done to assure accurate results, including white blood cell culture;
4) use of a molecular plasmid control in water versus a positive blood sample; and
5) different primer sequences and amplification protocol used to find the virus, which were not validated by a clinical control.


The WPI study was published after six months of rigorous review and three independent lab confirmations, proving that contamination had not taken place and that infectious XMRV was present in 67 percent of CFS patients diagnosed according to the Canadian and Fukuda criteria. In contrast, this latest study was published online after only three days of review. Significant and critical questions remain as to the status of patient samples used in the UK study as those samples may have been confused with fatigued psychiatric patients, since the UK has relegated “CFS” patients to psychiatric care and not traditional medical practices.

“Little is known about the prevalence of XMRV world-wide, much less the incidence of XMRV in ME/CFS or prostate cancer” emphasizes Dr. Judy Mikovits. “WPI and its NCI collaborators are actively engaged with international research teams to investigate these important questions.”

WPI does not recommend the use of anti-retroviral drugs that have yet to be proven to be effective in treating XMRV infection. However, several large pharmaceutical companies have expressed interest in developing anti-retroviral and immune modulating drugs that will effectively treat XMRV associated diseases.

WPI looks forward to the results of other scientific groups around the world, serious about replicating its scientific results, by using the same techniques as WPI and its collaborators. The fact that XMRV was detected in 67 percent of the CFS samples in the U.S. study determined a significant association between XMRV and CFS, demanding a much more serious inquiry by responsible health agencies around the world as to the cause of this debilitating disease.

-###-

Whittemore Peterson Institute
The Whittemore Peterson Institute for Neuro-Immune Disease exists to bring discovery, knowledge, and effective treatments to patients with illnesses that are caused by acquired dysregulation of the immune system and the nervous system, often results in lifelong disease and disability. The WPI is the first institute in the world dedicated to X associated neuro-immune disease (XAND), and other X associated diseases, integrating patient treatment, basic and clinical research and medical education.


Permalink to Comment

8. qetzal on January 7, 2010 6:14 PM writes...

I don't know who's right here, but WPI's press release seriously damages their credibility in my view. The tone is highly defensive, as if the Erlwein et al. was some kind of personal attack on them.

The PR lists a number of things that supposedly render Erlwein "meaningless." One of them (#4) is that "molecular plasmid control in water" was supposedly used as the positive control, instead of a positive control blood sample. In fact, the paper doesn't say whether the positive control was in water, buffer, spiked into patient DNA, or what. But in the comments on PLoS ONE, one of the authors confirms that the positive control WAS spiked into patient DNA. So that's at least one false accusation made by WPI's press release. I'm quite happy to believe that it was an error, not a deliberately false accusation, but it still suggests a willingness to make self-serving assumptions that aren't actually supported by the facts.

Finally, the very fact that WPI chose to respond by press release, instead of through normal scientific channels, makes me very skeptical of their motives.

Permalink to Comment

9. DCRogers on January 7, 2010 8:24 PM writes...

Since when is a reply to a scientific paper couched in legalistic, not scientific, terms ("These differences include, but are not limited to the following"), and released by an advertising/public relations agency ("R&R Partners is an integrated marketing communications firm that builds brand relationships across all audiences through such services as advertising, ...")?

If the lawyers left the room we might be able to watch an interesting discussion, but it's looking unlikely now that WPInstitute has lawyered up.

Permalink to Comment

10. KAti on January 7, 2010 8:27 PM writes...

The Wessley clan had a rushed, poorly designed study that did not follow the initial Science article protocol in their technique.

On need to ask, who benefits from that study?

All of the subjects were negative for XMRV. Don't you think it's a bit suspicious?

Their case definition is very questionable, and it is essential to use a VALID case definition for ME?CFS patients, like the canadian consensus.

LEt's compare apples with apples. Kids learn that really early.

Permalink to Comment

11. bbooooooya on January 7, 2010 8:34 PM writes...

This Whitmore institute is a joke: http://www.wpinstitute.org

Permalink to Comment

12. Bored on January 7, 2010 8:42 PM writes...

I agree with #9 DCRogers. Lawyering up is a sign that the Wizard doesn't want the curtain pulled back.

Permalink to Comment

13. Retread on January 7, 2010 8:56 PM writes...

I'm not sure it's kosher to republish a comment I made on your original post on XMRV, but here it is again.

"The WPI people are now saying that since the manuscript went in that further work has shown 98% of a 300-CFS-patient sample as positive for XMRV."

This ALMOST CERTAINLY DOES NOT PASS THE SMELL TEST. Few diagnostic criteria are 98% accurate (particularly those based on symptoms alone), so the group of 300 patients said to have CFS undoubtedly contains more than 2% who don't have the disorder (whatever CFS turns out to be) even though they have the symptoms.

However, classifying illnesses by symptom complex has a long and excellent history in medicine. Prior to the discovery of micro-organisms, infections were characterized by the type of fever they produced. Now we know that many distinct micro-organisms cause fever. Similarly, it is quite likely that there are multiple distinct causes of CFS (some of which might be one or more micro-organisms). It is very unlikely that 98% of CFS (whatever it is) is caused by one thing.

Permalink to Comment

14. qetzal on January 7, 2010 11:42 PM writes...

KAti asks:

On need to ask, who benefits from that study?

Right. Because only the people from the PLoS ONE study have any stake in this. Those folks over at WPI, they couldn't possibly have any bias right? After all, they work for an institute that "exists to bring discovery, knowledge, and effective treatments to patients with illnesses that are caused by acquired dysregulation of the immune system." The "first institute in the world dedicated to X associated neuro-immune disease (XAND), and other X associated diseases, integrating patient treatment, basic and clinical research and medical education." The one claiming a major new discovery, where "several large pharmaceutical companies have expressed interest in developing anti-retroviral and immune modulating drugs that will effectively treat XMRV associated diseases."

Nope. No reason for possible bias there. No sir-ee.

Permalink to Comment

15. qetzal on January 7, 2010 11:50 PM writes...

Sorry for the double post, but on the question of who benefits, I now see that WPI has licensed out their XMRV test, in response to "an overwhelming response." (link).

So indeed, let's consider who benefits here.

Permalink to Comment

16. Advocatus Diaboli on January 8, 2010 1:58 AM writes...

How does cutting non-management jobs improve R&D output?
________________________________________________
Pfizer and Merck signal deep cuts in R&D groups

http://www.fiercebiotech.com/story/pfizer-and-merck-signal-deep-cuts-r-d-groups/2010-01-07

Pfizer and Merck have begun to spell out exactly where the axe will fall as they each absorb a big new acquisition into their organizations. According to Pharmalot, Pfizer has told New Jersey officials that 400 people at Wyeth's old Monmouth Junction research center are getting the pink slip at the end of this month. And Merck will eliminate 500 jobs--mostly sales and administrative positions--from Schering-Plough's old headquarters in Kenilworth.

These layoffs are just the beginning, of course. Both pharma companies are planning deep cuts to eradicate any overlaps with the companies that they are swallowing. And in another ominous note for Big Pharma's embattled R&D organizations, Merck CEO Dick Clark (photo) told an audience attending a Goldman Sachs event that the company has to look at "the number of research sites you need" post-merger.

Permalink to Comment

17. oregano on January 8, 2010 5:30 AM writes...

Quetzal, it WAS a personal attack on WPI. The British "researchers" specifically mentioned the WPI paper. In fact, this was a rushed, poorly designed "study" for the purpose of countering any thought that ME/CFS has an organic cause. Wesseley, who is a psychiatrist, has co-written hundreds of papers selling the idea that ME is nothing but depression and "illness beliefs". He is also paid a lot of money by drug companies that sell antidepressants. He and his cronies specifically INclude depressed people, and specficialy EXclude those who have testable, verifiable organic symptoms for ME from their very definition of it.

Permalink to Comment

18. blick on January 8, 2010 8:01 AM writes...

I do not understand all of the animosity being directed toward WPI. It strikes me as venomous and somewhat premature. I have been suffering from a chronic fatigue type of illness for three years. WPI is one of the only organizations committed to seriously investigating this mysterious malady which, in my case, has caused, at times, complete incapacitation. Adding insult to injury, doctors have remained ignorant, even intransigent, funneling debilitated patients to shrinks for talk therapy and Prozac. Any perceived conflict of interest with VIP DX's XMRV test (Dr. Lombardi heads up that lab, and it is the only US lab offering the test) is offset by the fact that WPI was founded by, and named after, a family with a daughter who is very sick with CFS. It seems obvious that financial gain is not a motive here.

Permalink to Comment

19. fromsgc on January 8, 2010 10:04 AM writes...

#18, Can not tell for anybody apart from myself, but I REALLY do not like the immediate prees-relese worded in a very offensive, even libel way. Tottaly disgusting. Regardless of what I thought before this story - and I still think viral infection may contribute to the CFS - I know have very grievious doubts about the motives and methods of WPI folk.

Permalink to Comment

20. blick on January 8, 2010 10:14 AM writes...

Well what do you suspect WPI's real motives are, then?

Permalink to Comment

21. Anonymous on January 8, 2010 10:41 AM writes...

#18, you are being too unequivocal in your dismissal of financial incentives as affecting this discussion -- as demonstrated by the hiring of a PR firm, hardly a typical act of a scientific lab.

But rather than going down the unscientific rat-hole of guessing at motives, I will simply note that the disparity in results are SO LARGE as to ensure that further independent follow-on work will easily I.D. which emperor is strutting around with no clothes.

Permalink to Comment

22. qetzal on January 8, 2010 10:43 AM writes...

oregano,

It was a scientific study published by scientific researchers. It may well be wrong, but calling them "researchers" (with scare quotes) isn't persuasive.

Of COURSE they mention the WPI study. That provides the entire context for doing their study. It would be unacceptable if they DIDN'T mention the study. If you think that's evidence of a personal attack, perhaps you're not familiar with the expectations of scientific publishing.

I won't attempt to argue whether Wessely and "his cronies" have a non-scientific bias against the XMRV hypothesis. I'll accept, for the sake of argument, that they may well have.

The point is that WPI also has a clear and obvious potential bias in favor of the XMRV hypothesis. They're already selling XMRV diagnostic testing, for FSM's sake! Sure, it's through a license to another company. But it turns out that Lombardi, who was first author on the the study claiming a link between XMRV & CFS, is not only a member of WPI. He's also the Director of Operations for VIP Dx, which is the company selling the XMRV testing! (Thanks to blick for pointing that out.)

So the allegations of possible bias clearly cut both ways.

Let me be clear that I don't know whether either, both, or neither groups' claims to date have been influenced by their non-scientific biases. But I submit neither does anyone else. Trying to make a case for either side by claiming the other side is biased is naive, at best.

Permalink to Comment

23. W4TC on January 8, 2010 10:53 AM writes...

This study from King's College would be laughable were it not for the very damaging and misleading agenda behind it.

First, the study by the WPI had a rigorous 6 month peer review prior to publication. This King's College "study" was published in a matter of days, and was not peer reviewed.

The methodology was also seriousy flawed. According to the Scientific Director of the CFIDS Association of America (formerly of the CDC):

"The blood was collected from CFS patients in different types of blood collection tubes.
The genomic DNA was extracted and purified using different techniques.

The amount of genomic DNA included in the amplification assay was different.

Different primer sequences were used that amplified different regions of the XMRV proviral DNA.

The conditions of the PCR amplification assay were different – from the numbers of cycles, to the type of polymerase used.

Should these differences affect an investigator’s ability to detect XMRV? To a microbiologist with experience handling samples and studying various infectious agents (as I am), these variances in procedure could make the difference between detecting XMRV or not."

This was not a replication study attempt. It was a fast ditched, extremely flawed effort of group of *psychiatrists* with an agenda to dismiss CFS as the real, serious and biophysical illness that it is. Would anyone have taken a replication study attmempt by a group of pyschiatrists (vs. microbiologists trained in virology) in the early days of HIV testing? Of course not.

This UK study is meaningless.

Permalink to Comment

24. blick on January 8, 2010 11:01 AM writes...

Let me be clear: I am indeed very concerned with the ethical issues surrounding the VIP Dx XMRV tests. CFS patients are among the most vulnerable and desperate (Lombardi and co. know this) and the $650 price tag for PCR and culture tests is unlikely to be covered by insurance. VIP is the only lab offering this test. They can basically charge whatever they want. Supposedly, profits are being put back into WPI. If there's not an actual conflict of interest, there clearly exists an appearance of one. I do have a problem with this. But I remain willing to give them the benefit of the doubt.

Permalink to Comment

25. John on January 8, 2010 11:28 AM writes...

Regarding several of the points brought up-

1. XMRV and prostate cancer. There have actually been two seperate studies which found an association between XMRV and prostate cancer- the original study by De Risi et al, as well as a recent study by Singh et al.

2. The fact that no XMRV whatsoever has found in negative studies. There have been two seperate studies which reported a roughly 4% prevalence in otherwise healthy controls as well as a Japanese Red Cross report of a 1.7% prevalence in Japanese blood donors, so for the two XMRV/prostate cancer(XMRV/PC) studies and this XMRV/CFS study to not find any XMRV whatsoever in now approaching 1000 patients is kind of odd.(0/589 German XMRV/PC study, 0/139 Irish XMRV/PC study, 0/186 XMRV/CFS study)

3. That the WPI is financially motivated to sell tests. The WPI is a non-profit institute. I believe the founders of the WPI, Annette and Harvey Whittemore, opened VIPdx(the company selling XMRV tests) as a for profit subsidiary, but have stated their intent to plug any and all profits back into CFS research and treatment at the WPI, due to a decades long pattern of ignorance and prejudice in regards to government funding of CFS research. The Whittemores have already donated millions of dollars of their own money to the WPI in order to find a cure for their daughter Andrea who has been sick with CFS for the past 20 years.

4. The methodological rigour of the original study vs. the methodology of this study. The original study was made by the peer reviewers of Science to go back and find and re-find XMRV by numerous different methods. It was also replicated in three seperate labs- 1)the WPI, 2)the Cleveland Clinic, and 3)the NCI.

Permalink to Comment

26. Mark Elliott on January 8, 2010 11:29 AM writes...

To suggest that VIPdx is only conducting XMRV tests to make money is incorrect - they have stated that any money they make will be invested in further research for developing better tests. They don't claim that the tests they have now are for anything other that research purposes. Red Labs (in Belgium, I think) will soon be doing the same tests.

Three labs duplicated the same results, which is why it was published in "Science", the most prestigious scientific publication there is. In addition to the Whittimore Peterson Institute these labs are at the National Cancer Institute and the Cleveland Clinic.

The Wessely study is fraudulent when it claims to show that there is no XMRV in Europe, WPI tested 500 samples from the UK and got the same results as they got with their US samples. Wessely is to legitimate research what Fox News is to the New York Times.

Permalink to Comment

27. Anonymous on January 8, 2010 11:35 AM writes...

John -- Excellent points. Thank you for making them.

Permalink to Comment

28. sgcox on January 8, 2010 1:16 PM writes...

Sorry guys, but UK staudy - all the lab work, was done by very profeccional people in Jefferiss Research Trust Laboratories, Section of Infectious Diseases, Wright-Fleming Institute, Faculty of Medicine, Imperial College London. Just check pubmed for articles by first and second authors to see that they know what they are doing.
Just stop this nonsence that if it was published in Science by some american authors makes it certain and final truth. Sheesh !

Permalink to Comment

29. Siaz on January 8, 2010 4:08 PM writes...

sgcox... As far as I can see, no one here said that just because it was in Science or done by American researchers that it was certain and final truth. Not even the WPI is saying it's most certainly causal. They are only saying it's possible XMRV may play a role, given the findings. What people here are saying is that their study methods were much more well developed and rigorously tested than the UK study. Don't forget the Cleveland Clinic and National Cancer Institute (separate labs) also confirmed their results.

I'm looking forward to seeing valid replication studies that use the most accurate testing methods possible, and are extensively peer reviewed prior to publication. In my opinion, the UK study did neither of these things.

Permalink to Comment

30. sgcox on January 8, 2010 5:16 PM writes...

Well, I was just very irritated by W4TC, John and Mark comments which implied the infallability of Science paper authored by 3 American labs.
I do not have any connections whatsoever with UK labs involved but I resent the blatant and vicious attack by WPI associates, sympthatizers and people just taking sides.
I also resent selling $560 kit (and pocketing money as a director of the company based solely on your controverial paper)to sick people which will not benefit whatsover from it, not even placebo effect !

I just dont like this whole WPI reaction and business angle. Just does't feel right for me, sorry.

Permalink to Comment

31. Petra on January 8, 2010 7:14 PM writes...

All politics aside, because of the similar discrepancy between the US & European prostate cancer XMRV studies, seems to me the only two possibilities are A)XMRV occurs in the US but not in Europe, or B)The European lab techniques are unable to detect it. No? Or, I suppose, C)that the American (and Japanese) lab techniques are faulty and XMRV does not occur in humans at all?

Permalink to Comment

32. Hip on January 8, 2010 9:10 PM writes...

Note that: One of the co-authors of this study, Simon Wessely, has a vested interest in the outcome of such virus studies. Simon has staked his entire academic career on the idea that diseases like chronic fatigue syndrome / myalgic encephalomyelitis are caused by purely psychological factors.

Therefore Simon Wessely would be the last person you would want in a study like this. I wonder just how hard he looked for this XMRV virus.

Ever heard of confirmation bias?

Permalink to Comment

33. Hip on January 8, 2010 9:24 PM writes...

>> ALSO, Simon Wessely and company often use a different set of criteria to select the patients for their "CFS" studies (such as the Oxford Criteria). These selection criteria are set up so as to include lots of people that are just depressed, who do not have CFS at all.

As a consequence, it is not surprising many studies, based on the Oxford Criteria or similar, find that patients do not have XMRV: they studied the wrong people!

In other words, when Simon Wessely says "CFS", he actually is talking about "depression". Wessely loves to play language games, and frequently bends the definition of terms. You would be surprised how easily this fools people. Wessely has his own agenda.

The original XMRV research at the Whittemore Peterson Institute used the Canadian Consensus definition of CFS/ME, which most researcher say is the definition that everyone should abide by. The advantage of the Canadian criteria is that they actually select CFS patients, and not just a ragbag of various people that have depression, and other disorders.

Permalink to Comment

34. qetzal on January 8, 2010 10:01 PM writes...

Hip,

Have you considered that Lombardi et al. & WPI stand to make their careers on XMRV?

You people who think bias can only go in one direction are either foolish or deluded.

Permalink to Comment

35. retread on January 8, 2010 10:30 PM writes...

Comments about motivation are probably relevant at this point. But the presence or absence of XMRV nucleotide sequences is about as objective a finding as one could hope for.

A fairly simple solution would be to have a third group obtain samples from a new set of CFS patients (with the criteria used for diagnosis clearly stated) along with plenty of normal controls l, send them blinded to both sets of labs and see what happens (along with running the test themselves). Hopefully something like this is already in the works.

Remember a diagnostic test that is 99% accurate for condition X will produce false positives 50% of the time if the prevalence of condition X is 1%. Testing only CFS patients is not a good idea presently, but certainly was a decent place to start. Time to move on.

My guess is that the original XMRV work won't hold up. As always, there is no substitute for data.

Permalink to Comment

36. Mark Elliott on January 9, 2010 1:20 AM writes...

WPI tested both people with CFS and age and sex matched controls, 3.7% of whom tested positive. Read the study!

Permalink to Comment

37. Julie on January 9, 2010 9:06 AM writes...

A replication study should surely do just that...replicate a study. If the study was not fully replicated then surely it should not be included within the research project. There are replication studies taking place all around the world and the results should be due in towards the middle of the year, surely only then are we in a position to judge the work carried out by WPI. For me I am just so grateful that someone is attempting to get to the bottom of this disabling illness and I will support anyone who is truthfully trying to do that...one thing I am positive of though, that it is not phsychologically based and having a pschiatrist championing the cause for CFS/ME in the UK is like having a plumber in charge of a housing development (no disrepect to plumbers!).

Permalink to Comment

38. Siaz on January 9, 2010 9:07 AM writes...

First, my apologies my previous message got posted 4x. I hope the owner of this site can delete the duplicates. I kept getting error messages when I hit "send."

As for the WPI, I thought their press release was professional and respectful, and simply stated the facts --that the UK study methodology was flawed.

And as for their motives... the WPI, a non profit organization, was established by a doctor studying CFS for 20 years, and by a set of parents who have a daughter with severe ME/CFS. It was reported in the NY Times that she now suffers from seizures as a result of the disease. The WPI's only agenda is to try to help people with this hugely serious and debilitating disease to get their lives back.

Don't forget, the WPI compared CFS patients (who met both the Fukunda AND Canadian Definition) as well as healthy controls. 67% of those with CFS had the virus, vs. about 4% of controls. It's extremely important when studying CFS that the patient population actually *has* CFS (ie, meets the criteria for diagnosis, most preferably by using the strict Canadian Case Definition).

Also, the study in Science was not just the WPI. The study was duplicated by labs at the Cleveland Clinic and the National Cancer Institute.

In my opinion, the Science study was a supieror study all around. I look forward to more labs using the same high standard testing methods, and the same guidelines for patient population. In other words, I look forward to real replication studies.

Permalink to Comment

39. Kati on January 9, 2010 10:27 AM writes...

Chronic fatigue syndrome patients (I hate the name of this disease, it is derogatory and insulting) are ridiculed day after day after day for having an illness supposedly with no biological markors. The CDC and governments especially in the IUK have traditionally made a point to say that it's all in our head, a psychiatric disease. The UK study has been directed by Simon Wessley who is